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Telebehavioral Health Informed Consent

Kim Vander Griend verified by GoodTherapy.org


"The Person Who Moves A Mountain Begins By Carrying Away Small Stones".

- Confucius -


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hello@lifepaththerapy.org

(312) 940-3655

(312) 374-4966

25 E Washington Street Suite 1835 Chicago, IL 60602



25 E Washington Street Suite 1835
Chicago, IL 60602

hello@lifepaththerapy.org
Phone: (312) 940-3655
Fax: (312) 374-4966


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By submitting this form via this web portal, you acknowledge and accept the risks of communicating your health information via this unencrypted email and electronic messaging and wish to continue despite those risks. By clicking "Yes, I want to submit this form" you agree to hold Brighter Vision harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means.